Sue Johnson – The Bone Builder

Origins & Background

Sue Johnson is a Canadian clinical psychologist, researcher, and one of the leading developers of Emotionally Focused Therapy (EFT). Her work has been instrumental in integrating attachment theory into couples therapy, emphasizing emotional bonding as the key driver of change in romantic relationships.

Health vs. Dysfunction

Johnson defines relationship health through the lens of emotional responsiveness, safety, and secure attachment. Dysfunction emerges when couples experience disconnection, emotional withdrawal, or negative reactive cycles that erode trust and intimacy. Healing requires restructuring these patterns into moments of attunement and emotional presence.

Theory of Change

Change is fostered when partners are able to share vulnerable emotions and receive responsiveness from one another. By accessing primary emotions and creating new emotional experiences, couples develop new patterns of secure bonding. The shift from blame to emotional accessibility is central to EFT.

Nature of Therapy

Emotionally Focused Therapy is structured, experiential, and deeply relational. The therapist helps couples move through identifiable stages: de-escalation, restructuring interactions, and consolidation. The approach is non-pathologizing and focuses on building emotional safety rather than diagnosing dysfunction.

Role of the Therapist

The EFT therapist is an active process guide and emotional coach. Their job is to slow down reactive cycles, uncover core emotions, and choreograph new relational dances. Johnson refers to the therapist as a "secure base" from which clients can explore emotional risk and reach for connection.

Assessment & Goals

Therapists assess each partner's attachment history and the couple’s negative interaction cycles. The primary goal is not problem-solving, but deep emotional engagement and responsiveness. Progress is measured by the partners’ ability to reach, respond, and repair emotional ruptures.

Treatment Planning

Treatment plans in EFT follow a structured sequence: de-escalate conflict, restructure interactions to create new emotional experiences, and consolidate secure bonds. The process is adaptable for couples, individuals, and even family therapy formats.

Typical Interventions

Core interventions include enactments (in-session emotional dialogues), accessing vulnerable emotions, reframing interaction patterns, and tracking emotional cycles. The therapist may say, “Can you tell them that right now?” or “What’s happening inside as you hear that?” to facilitate bonding moments.

Cultural Considerations

Johnson emphasizes that attachment needs are universal, though cultural norms may shape emotional expression and vulnerability. EFT has been adapted for diverse populations and has growing research support across cultures and sexual orientations. Therapists are encouraged to hold cultural humility and explore systemic barriers to emotional safety.